Posted by theo on February 15, 2005, at 14:35:15
In reply to Re: Does Depakote help with Depression or just Mania? » theo, posted by Ritch on February 15, 2005, at 9:49:40
> > So Depakote is hard on your liver? Did it give you cognitive difficulties, make you sloth like in general? How much did or are you taking and are you taking it once or twice daily, regular or ER version?
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> I'm taking 250mg ER at bedtime, and then occasionally an extra 125mg of sprinkle midday. I don't get cog difficulties on Depakote as badly as with lithium or Trileptal and certaintly not as bad as Gabitril or Topamax. Depakote has been around a long time so all the bad stuff that's ever happened is all fairly well documented and there is a black box warning about rare possibility of hepatic failure and potentially fatal pancreatitis. The chances for the liver thing tend to decrease with age and it (Depakote) is generally riskier to use in younger rather than older people. Lithium, OTOH, tends to get more troublesome in older age groups (because therapeutic doses are close to toxic doses). I get liver function tests every so often and thus far have come up ok, so I'm not real worried. Depakote does produce some asthenia (muscle weakness), but then so does Keppra.. Did you notice the "rag doll" feeling on it? In my case it wasn't accompanied by any internal restlessness, that's why I think it may be an acceptable alternative antimanic for me.
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> > I forgot to mention one thing about Keppra, I had to take it 3 times daily instead of just 2. The half life is 6-8 hours and I don't understand why the PI sheet doesn't suggest this. It even says it clears fast and doesn't really "build up", it's in and out. Keppra doesn't seem to smooth out to be able take twice daily, at least for me. What about you, how much and when do you take it?
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> Yes, I did notice a mild "rebound" effect in the middle of the next day.. I went as high as 750mg/day. 500mg at bedtime + 250mg midday. Anyhow, I found that 250mg at bedtime was plenty enough for good sleep. 125mg doses during the day seemed to work ok. Probably two 250mg tabs per day (1 tab at bedtime, 1/2 tab twice during the day) probably would be the best dose for me. The trouble is that they price the stuff the same no matter what strength you buy, so you will pay $$$ for the convenience. Splitting unscored halves of tablets in two wind up with a lot of dust.. don't know if you noticed that or not :)So are you going to stop Depakote ER and try Keppra alone for mania?
I know what you mean about the rag doll effect. It seems to lessen, or maybe I just get used to it, over time. What's weird is that it makes me physically weak, and mentally charged. Can you relate?
When you were at 750mg, did you feel like it was to much? I know when I first start Keppra, I'm a little tired and once I hit 750mg I kind of get charged up, maybe even a little aggressive.
Would you say overall that Keppra is better with less side effects than Depakote ER for anxiety? I'm tempted to try it but at the same time don't know if I have it in me to try another med.
poster:theo
thread:457547
URL: http://www.dr-bob.org/babble/20050212/msgs/458226.html